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Sex and Intimacy After Ovarian Cancer Diagnosis

There Is Life After Cancer

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Updated August 14, 2008

Although sexuality and intimacy are perhaps not at the top of your list when grappling with upcoming cancer treatment, this represents one way to ease anxiety, release stress and help you recover. Sometimes sexual intimacy may be restarted during treatment or upon completion of treatment, depending upon what is planned. It's important to recognize what is possible and what to anticipate. Some treatments will have more of an impact than others. Acknowledging what may be upcoming may also empower you with enough information that might help you decide between options. Ultimately, being prepared will also allow you to think about and see the light at the end of the tunnel towards regaining a normal life. It may help keep your eye on the prize.

Body image changes include physical changes to your body which may be lasting or temporary. However, they may also be due to perceived changes inside your body which affect your psyche and emotions, usually related to hormonal imbalance caused by treatment. What are the most common side effects? The possibilities of having side effects and the extent of side effects hinge on what type of treatment is planned. The following are the most likely to occur:

* Loss of desire
* Difficulty achieving an orgasm
* Shortening or narrowing of the vagina
* Painful intercourse
* Vaginal dryness

Please remember that not everyone will get side effects. These are just the possibilities. Some will have none, other people may have a lot of associated problems. Sometimes the side effects can be of brief, others may be lifelong.

Chemotherapy


Chemotherapy, which is usually injected through the vein, touches your whole body. Loss of desire, or libido, is very common during chemotherapy. First of all, if nausea and vomiting occurs, and hair loss occurs, it is difficult to feel intimate or desirable. When the chemo related effects disappear, these sexually associated consequences generally improve. Sometimes, the psychological shock of body image alteration can persist and it could take a long time to regain feelings of sensuality and desire for closeness. Physically, chemotherapy affects the ovaries, which produce estrogen and testosterone. If the ovaries are already removed or you are menopausal this won't add to the problem, but in some early ovarian cancers one ovary is left behind.

Depending upon the type of chemo, these can be temporary or lasting disturbance with output of these hormones. Diminution in hormone levels may cause flushes, soaking sweats, mood swings, loss of desire, and vaginal dryness. In turn, vaginal dryness can cause painful penetration and coitus. Depending upon the type of cancer you have (hormone sensitive or not), it's conceivable to prescribe hormonal replacement therapy. This may include both estrogen for menopausal symptoms and testosterone for finding desire. If the cancer is estrogen sensitive, it's generally not a good idea to consume estrogen. All the same,there's no medical proof that estrogen replacement in ovarian cancer impacts survival. There are also weaker bio-identical hormones available from plant sources. It's a difficult issue and you ought to discuss your specific situation with your doctor.

Surgery

Ovarian cancer cytoreductive surgery frequently calls for removal of a lot of organs in the pelvis. It may just be the uterus and ovaries or include part of the rectum as well. Often, in spite of surgical measures to prevent this (such as putting the omentum, a fatty carpet inside you, in that area behind the vagina), after this area of the bowel is removed, there's no "shock absorber" behind the vagina. The vagina can fall backwards in the pelvis and get stuck to the muscle and bone. This results in possible pain on intercourse and possible need to change sexual habits and positions in order to make the angle of penetration as comfortable as possible. If the ovaries are removed, and you've not experienced menopause, the same symptoms as repeatedly mentioned above can happen.

Occasionally only partial removal of the intestine/rectum is required and the two ends are reconnected, averting a colostomy bag. The closer the removal of colon/rectum is to the anus, the greater the chances of a colostomy bag. Clearly, this is a body image change and psychological/emotional issues regarding sexuality are important to address. Even if a colostomy is needed, there are ways to avoid a bag by "training" colostomies to be dry, among other alternatives.
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